Fungal keratitis is a significant ocular infection that can lead to monocular blindness, particularly following minor ocular trauma. The present study aims to evaluate the epidemiology, microbiological profile, and clinical outcomes of patients presenting with fungal keratitis, with an emphasis on early diagnosis and preventive measures. A total of 196 corneal scraping samples from patients with suspected fungal keratitis were analyzed. Direct microscopy using potassium hydroxide (KOH) mount and fungal culture were performed. Demographic data, clinical history, risk factors, and treatment outcomes were recorded and analyzed. Out of the 196 samples, 64 (32.7%) yielded positive fungal isolates. Among these, 48 cases (75%) were positive on both direct microscopy and culture. Aspergillus species emerged as the predominant isolate, accounting for 63% of the fungal isolates, followed by Fusarium species (22%). The incidence was higher in males (72%) compared to females (28%), with 41% of the patients identified as diabetics. The most common etiological factor was trauma with particulate matter (58%), followed by vegetative matter (13%). Clinical outcomes revealed that 66% (42 patients) were successfully treated and cured, 31% (20 patients) developed corneal scarring, and 2 cases progressed to complete monocular blindness. The predominance of Aspergillus and Fusarium species underlines the need for targeted antifungal therapy. Early identification through direct microscopy and culture plays a critical role in successful management.

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